Provider Demographics
NPI:1194554113
Name:D'CRIMMON CARE LLC
Entity type:Organization
Organization Name:D'CRIMMON CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARIFA
Authorized Official - Middle Name:
Authorized Official - Last Name:UREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-843-0641
Mailing Address - Street 1:2827 GIRARD AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-1320
Mailing Address - Country:US
Mailing Address - Phone:763-843-0641
Mailing Address - Fax:
Practice Address - Street 1:2827 GIRARD AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1320
Practice Address - Country:US
Practice Address - Phone:763-843-0641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-29
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty